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[Q热:当前的诊断与治疗选择]

[Q fever: current diagnosis and treatment options].

作者信息

Million M, Lepidi H, Raoult D

机构信息

CNRS, UMR 6236, IRD 198, unité de recherche sur les maladies infectieuses et tropicales émergentes, faculté de médecine, université de la Méditerranée, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France.

出版信息

Med Mal Infect. 2009 Feb;39(2):82-94. doi: 10.1016/j.medmal.2008.07.008. Epub 2008 Nov 14.

Abstract

Q fever is a zoonotic disease caused by the ubiquitous pathogen Coxiella burnetii responsible for acute and chronic clinical manifestations. Its geographically heterogeneous prevalence seems mainly related to the clinician interest and the availability of a reference center. Its polymorphic clinical expression imposes reference to diagnosis in presence of pneumonia, hepatitis, prolonged fever or endocarditis with no proof of its etiology. The diagnosis is mainly serological. If acute Q fever is most often benign, endocarditis is constantly fatal without treatment. The treatment is effective and well tolerated, but must be adapted to the acute or chronic pattern, the presence of a heart valve disease, an aneurysm or a vascular prosthesis, an immunodeficiency and the specific problem of pregnancy.

摘要

Q热是一种人畜共患病,由无处不在的病原体贝纳柯克斯体引起,可导致急性和慢性临床表现。其在地理上的异质性流行似乎主要与临床医生的兴趣以及参考中心的可用性有关。其多态性临床表现在出现肺炎、肝炎、长期发热或心内膜炎且病因不明时需要参考诊断。诊断主要依靠血清学。如果急性Q热大多情况下是良性的,那么心内膜炎若不治疗则必然致命。治疗是有效的且耐受性良好,但必须根据急性或慢性模式、心脏瓣膜疾病、动脉瘤或血管假体的存在、免疫缺陷以及妊娠的具体问题进行调整。

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